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Neurology / Psych > Week 3 - Psych > Flashcards

Week 3 - Psych Flashcards

(47 cards)

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1
Q

Sleep neurotransmitters

A

REM: ACh
NREM: serotonin

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2
Q

EEG patterns in sleep

A

Awake: low voltage, random alpha and beta waves
Stage 1: Theta
Stage 2: sleep spindles and K-complexes
Stage 3,4: delta (high voltage)
REM: similar to awake, with sawtooth waves

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3
Q

REM sleep

A

25%, every 90min, each 10-40min, longer in 2nd half of night
BP, pulse, resp increase
penile erection
skeletal mm paralysis

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4
Q

NREM sleep

A

1: 5%, BP, T decrease, easily awoken
2: 45%, body fxn continues to slow
3,4,: 25%, deep sleep, mostly during 1st half of night, much less easy to wake

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5
Q

Aging sleep changes

A

less REM, less 3/4

increased awakenings, decreased efficiency

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6
Q

Depression sleep changes

A

frequent awakenings, early morning
decreased REM latency, increased total REM
decreased 3/4

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7
Q

Dyssomnias

A

Narcolepsy= sleep attacks, cataplexy, sleep paralysis, hallucinations,, decreased REM latency, less overall REM,, hypocretin (orexin) deficiency
Circadian rhythm sleep disorder= going to bed too early or late
Restless leg Syndrome= limb jerking, frequent awakenings, older adults and pregnant, tx using antiparkinson
Sleep apnea= frequent awakenings, obstructive or central, resp acidosis, older obese men
Insomnia/hypersomnia= 3x/week for at least 1mo

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8
Q

Parasomnias

A

Bruxism= tooth-grinding, during stage 2
Sleep terrors= repetitive fright, not easily awakened, no memory on wake, during 3/4, usually kids
Sleep walking= no memory upon wake, stage 3/4, usually kids
REM sleep behavior disorder= during REM

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9
Q

Determinants of personality

A

Temperament(nature), character(nurture), development(nurture+biology), psyche(self-awareness)

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10
Q

Defense mechanisms

A

Instincts (Id) + conscience (super ego) = defenses (Ego)
are universal, and work, but can be problematic when too rigid despite changing conditions
Denial, Dissociation, Suppression

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11
Q

Ego-syntonic vs dystonic

A

Personality disorders are usually ego-syntonic, which means it doesn’t bother the patient, just the people around them
e.g. OCD vs OCPD

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12
Q

Cluster A personality disorders

A

Detached, eccentric type
Schizoid= emotionally detached, don’t want relationships, males, NO psychotic sx like in schizophrenia
Schizotypal= eccentric, highly genetic
Paranoid= long-standing mistrust without basis, males, no hallucinations

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13
Q

Cluster B personality disorders

A

Dramatic, impulsive type
Antisocial= impulsive, aggressive, disregard safety, lack of remorse, “sociopath”, genetic
Borderline= frantic efforts to avoid abandonment, unstable and intense interpersonal relationships, mood swings, emptiness, suicidal, females more, genetic
Histrionic= overconcern with appearance and attention, females
Narcissistic= heightened sense of self-importance, lack empathy, arrogant, entitled, envious

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14
Q

Cluster C personality disorders

A

Anxious type
ACPD= perfectionism, details, inflexible, males more, oldest children, ego-syntonic (as opposed to OCD)
Avoidant= extreme sensitivity to rejection, socially withdrawn, shy but desire relationships
Dependent= lack of self-confidence, put others needs behind their own, uncomfortable alone, females, youngest children

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15
Q

Generalized Anxiety Disorder (GAD)

A

excessive anxiety and worry
occurring majority of days for 6mo
not part of axis 1 disorder, or substance abuse
3/6 of: restlessness, fatigued, blank mind, irritable, muscle tension, sleep disturbance

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16
Q

Obsessive Compulsive Disorder (OCD)

A

Obsessions (recurrent and persistent thoughts that cause anxiety) AND compulsions (repetitive behaviors or mental acts)
Pt knows that it is not normal (ego-dystonic)
not due to axis 1 or substances

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17
Q

Social anxiety disorder

A

marked and persistent fear of social performance situations
person recognizes the fear is unreasonable (ego-dystonic)
affects the pt life, not due to substance

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18
Q

Bleuler’s 4 A’s of Schizophrenia

A

Associations
Affect
Autism
Ambivalence

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19
Q

Diagnosis of Schizophrenia

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A

2 of: delusions, hallucinations, disorganized speech, catatonic behavior, negative sx
need social and occupational dysfunction
lasts for at least 6mo
schizoaffective and mood disorder ruled out
no drugs on board, no pervasive developmental disorder

Positive (delusions, hallucinations, behavior)- get better over time
Negative (social isolations, withdrawal, anergy, blunted affect)- get worse over time
Cognitive (impaired abstract thinking, problem-solving)

20
Q

Old schizophrenia classifications

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A 
catatonic
disorganized
paranoid
residual
undifferentiated
21
Q

Etiology/Path of Schizophrenia

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A 
genetic predisposition
enlarged ventricles, reduced frontal lobe activity
Dopamine pathways:
-Mesolimbic hyperactive- positive sx
-Mesocortical hypoactive- negative sx
22
Q

Schizophrenia spectrum psychotic disorders

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A 
Schizotypal personality disorder: oddness
Schizophreniform disorder: 1-6mo
Schizoaffective disorder: mood sx
brief psychotic disorder: less than 1mo
etc
23
Q

Neurobio of addiction

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A

Dopamine
reward pathways: mesolimbic and mesocortical
-prefrontal cortex, nucleus accumbens, ventral tegmental area

relative dopamine deficiency when drug use is stopped- craving

24
Q

Conditioning

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A 
Positive reinforcement (use of drug enforces behavior)-- opiates, cocaine, amphetamines
Operant= reinforced patterns of behavior
Classical= craving and euphoric recall in using setting, paraphernalia
Negative reinforcement (use of drug removes negative condition, avoiding withdrawal)-- benzos and opioids
25
Detox medications
Alcohol: benzos, phenoparbital, vitamins Opiates: clonidine, loperamide Stimulants: sleep, food, water
26
Opioid intoxication and withdrawal
Intox: pupillary constriction Withdrawal: dysphoric, nausea, pupillary dilation, piloerection, sweating, diarrhea, fever, insomnia
27
Post Traumatic Stress Disorder (PTSD)
exposure to actual or threatened death, injury, violence Intrusions: persistently re-experience the traumatic event/s Avoidance: avoiding memories or external triggers of memories,, inability to recall aspects of the trauma ((over-control vs under-control)) Hyperarousal: sleep disturbance, exaggerated startle Mood changes: depression, etc -lasts more than 1mo
28
Neurobiology of PTSD
Amygdala hyperactivation (more activation = more fear) Hippocampus reduced volume (contextualizes fear) Prefrontal cortex less activation (inversely related to amygdala)
29
PTSD Therapy
sometimes can only remember things when in the same emotional state, so try to recreate that (CBT) talk therapy flooding or systematic desensitization also drugs
30
PTSD physician screening tool
Type 1: single incident (flashbacks, avoidance, hypervigilance, etc) Type 2: prolonged/repeated trauma (somatic complaints, depression, memory problems)
31
Age specific signs of stress
Infant - strangers and sudden stimulation Toddler - animals, temper tantrums, soiling/wetting Preschool - monsters, phobias, masturbation School age - burglars, obsessions, lying, stealing Adolescents - death, acting out, substance abuse
32
Autism
failure to develop age appropriate peer connections | stereotyped behavior, lack of eye contact
33
Stuttering
ignore in age 3-4 | only 1% require treatment
34
Oppositional defiant disorder
negativistic, defiant, hostile for more than 6mo kids and adolescents - more males cause: parents over-exert control
35
Attention deficit disorder (ADD)
fidgity or restless, easily distracted partially hereditary Tx: medications and psychotherapy
36
Conduct disorder
frequent lying, stealing, running away from home older kids and teenagers, more males can continue to cause probs as adults Tx for depression and maybe Lithium
37
Generalized anxiety and separation anxiety disorder (GAD and SAD)
GAD- constant worrying, unable to relax SAD- unable to leave parents children and teenagers, (GAD older than SAD) stress and familial anxiety can play a role Tx: meds and psychotherapy
38
Elimination disorders (enuresis and encopresis)
elimination fo urine or feces in inappropriate places boys more,, after age 4 for encopresis, 5 for enuresis Tx: imipramine, DDAVP
39
Reactive attachment disorder
inhibited, withdrawn, excessive or inappropriate interaction with strangers Cause: maltreatment, constant changes in care providers Tx: better parenting
40
Anorexia nervosa
think you're fat when you're not, restricts food or excessive exercise,, body-image problem weight loss to 85% of ideal, intese fear of weight gain, amenorrhea can get hypothermia, hypotension, bradycardia mostly girls, mostly teenagers,, perfectionists Refeeding syndrome: from correcting too quickly, can cause hypophosphatemia- arrhythmias Tx: NO pharmacology,, just psycho and food
41
Bulemia nervosa
``` binging and purging mostly teenage girls, older than anorexia,, overachievers, ego-dystonic at least 2/week for 3mo unduly influenced by body image Signs: swollen cheeks, abrasions of knuckles, moth eaten front teeth, arrhythmias, electrolyte imbalance Metabolic alkalosis Hypokalemia - arrhythmias Tx: SSRIs ```
42
Tourette's disorder
quick body movement (tics) or saying words/sounds more boys, usually age 7-10 problem with basal ganglia usually a lifelong problem
43
Tic disorder
single or multiple motor or vocal tics age 8-10, usually transient rule out hungtingtons, wilsons, encephalitis, stimulants
44
Medical illness effect on kids
Infancy: separation from parents, stranger anxiety early child: separation, fear of bodily harm school age: behavior regression, irrational explanation of illness adolescence: loss of privacy and autonomy Parents: mourning, anger, guilt
45
Binge-eating disorder
like bulemia, but no compensatory behavior (no purging)
46
Avoidant/restrictive food intake disorder
like anorexia, but no body-image/weight problems
47
Reasonable weight loss
5-10% of body weight of 6mo 1-2lb/week cut intake by 500-1000 cal/day kids: goal is to maintain weight, not lose

Neurology / Psych (8 decks)

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